Immune recovery is associated with persistent rise in hepatitis C virus RNA, infrequent liver test flares, and is not impaired by hepatitis C virus in co-infected subjects
Immune recovery is associated with persistent rise in hepatitis C virus RNA, infrequent liver test flares, and is not impaired by hepatitis C virus in co-infected subjects
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DOI：
10.1097/00002030-200209270-00008
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发表时间：
2002-09-27
期刊：
影响因子：
3.8
通讯作者：
Sherman, KE
中科院分区：
文献类型：
--
作者：
Chung, RT;Evans, SR;Sherman, KE
目的：高效抗逆转录病毒治疗（HAART）对丙型肝炎病毒（HCV）的影响尚不清楚。我们分析了参加 AIDS 临床试验组试验的合并感染患者的 HCV RNA 变化和肝毒性频率，并确定 HCV 是否会损害这些人群中成功的免疫重建。 设计/方法：在对四项试验中完成至少 16 周 HAART 的合并感染患者以及使用其他已完成的 HAART 试验中可用储存血浆的合并感染患者进行的前瞻性分析中，在基线和第 48 周测量了 HCV RNA。对单项试验中 40 名 HCV-RNA 阳性和 129 名 HCV-RNA 阴性患者的免疫恢复情况进行了回顾性分析。结果：前瞻性分析：60 名患者完成了至少 16 周的 HAART。平均 HCV-RNA 水平在第 16 周增加了 0.35 log(10) IU/ml，在第 48 周增加了 0.43 log(10) IU/ml。当按基线 CD4 细胞计数分层时，对于进入 CD4 细胞计数 < 350 个细胞/mm(3) 的受试者，HCV-RNA 水平在第 16 周和第 48 周分别增加了 0.43 和 0.59 log(10) IU/ml，但仅第 16 周和第 48 周时，入门 CD4 细胞计数 > 350 个细胞/mm(3) 为 0.26 和 0.1 log(10) IU/ml。仅 3.3% 的人出现严重丙氨酸转氨酶升高。回顾性分析：与未感染对照相比，HCV 合并感染对第 16 周或第 48 周时的总体平均 CD4 细胞增加没有影响。结论：在接受 HAART 的 HCV 合并感染患者中，免疫恢复与 HCV RNA 持续增加相关，尤其是基线 CD4 细胞计数 < 350 个细胞/mm(3)。 HCV 合并感染不会拮抗 CD4 细胞对 HAART 的反应。 (C) 2002 年利平科特·威廉姆斯和威尔金斯。
Objectives: The impact of highly active antiretroviral therapy (HAART) on hepatitis C virus (HCV) is unknown. We analysed changes in HCV RNA and the frequency of hepatotoxicity in co-infected patient enrolling in AIDS Clinical Trials Group trials, and determined whether HCV impairs successful immune reconstitution in these populations.Design/methods: In a prospective analysis of co-infected patients completing at least 16 weeks of HAART in four trials, and co-infected patients with available stored plasma from two other completed HAART trials, HCV RNA was measured at baseline and to week 48. A retrospective analysis of immune recovery in 40 HCV-RNA-positive and 129 HCV-RNA-negative patients from a single trial was performed.Results: Prospective analysis: 60 patients completed at least 16 weeks of HAART. The mean HCV-RNA level increased 0.35 log(10) IU/ml at week 16 and 0.43 log(10) IU/ml at week 48. When stratified by baseline CD4 cell count, subjects' HCV-RNA levels increased 0.43 and 0.59 log(10) IU/ml at weeks 16 and 48 for entry CD4 cell counts < 350 cells/mm(3), but only 0.26 and 0.1 log(10) IU/ml at weeks 16 and 48 for entry CD4 cell counts > 350 cells/mm(3). Severe alanine aminotransferase elevations occurred in only 3.3%. Retrospective analysis: HCV co-infection had no effect on the overall mean CD4 cell increase at weeks 16 or 48 compared with uninfected controls.Conclusion: In HCV-co-infected patients undergoing HAART, immune recovery is associated with a persistent increase in HCV RNA, especially with baseline CD4 cell counts < 350 cells/mm(3). HCV co-infection did not antagonize the CD4 cell response to HAART. (C) 2002 Lippincott Williams & Wilkins.